Should Your Child Get the HPV Vaccine?

A pediatrician explains how the HPV vaccine protects children from cervical cancer and other cancers later in life.

A woman speaking to a pre-teen about the HPV Vaccine

An estimated 14,100 new cases of cervical cancer will be diagnosed in the U.S. and an estimated 4,280 women will die of the disease in 2022, according to the American Cancer Society. But many cervical cancer cases can be prevented in the future, thanks to the vaccine for human papillomavirus (HPV), the virus that causes cervical cancer and five other cancers.

The HPV vaccine was introduced in the U.S. in 2006, and data show it is working, says Dr. Ashley Stephens, a pediatrician at the NewYork-Presbyterian Ambulatory Care Network. The Centers for Disease Control and Prevention (CDC) recently found that HPV infections that cause most HPV cancers dropped by 88% in females age 14 to 19 and 81% in women age 20 to 24, compared to before the vaccine was available.

For Cervical Health Awareness Month, Dr. Stephens, also an assistant professor of pediatrics at Columbia University Vagelos College of Physicians and Surgeons, answers questions about the HPV vaccine and how it can prevent cervical cancer as well as other cancers in people of all genders.

“Getting vaccinated can prevent 90% of cancers caused by HPV,” says Dr. Stephens. “As a pediatrician, I do everything I can to keep kids healthy, and I recommend all children get the HPV vaccine since we know it prevents cancer and saves lives.”

Headshot of Dr. Ashley Stephens

Dr. Ashley Stephens

What is HPV and who does it affect?
HPV is a very common virus that can infect anybody. About 80% of people will be infected with the virus at some point in their lives. While most infections clear on their own, some people will develop cancer as a result.

The problem is that people usually don’t know when they have been infected because most of the time you don’t have any symptoms, and HPV-related cancers are often diagnosed when people are in their 40s, 50s, 60s, and even older.

Aside from screenings for cervical cancer, there are no routine tests for other HPV-related cancers. As a result, HPV-related cancers often aren’t detected until somebody has symptoms, which can be late in the disease and mean the outcome may not be great. That’s why it’s really important for people to get the HPV vaccine, ideally before they’re ever exposed to HPV.

What cancers are linked to HPV infection, and how many people are affected?
Every year in the U.S., there are about 21,000 cases of cancer caused by HPV in women and about 15,000 in men, according to the CDC.

HPV causes almost all cervical cancers. And cervical cancer is the most common HPV-associated cancer in adults who have female genitalia. These adults also can get cancer of the vagina or the vulva — the external genitals.

For adults with male genitalia, the most common HPV cancer is oropharyngeal cancer, which is cancer of the back of the mouth and the throat. They can also get penile cancer from HPV. And all adults can get anal cancer.

How does HPV spread?
The most common way it’s transmitted is through skin-to-skin contact in the genital area during sexual contact. Rarely, HPV can be transmitted from a mother to a baby during birth.

How does the vaccine work and how effective is it?
The HPV vaccine contains particles that look like the HPV virus, which prompt your child’s body to generate antibodies that protect them from an infection if they’re exposed to HPV in the future. They can’t get HPV from vaccination.

The vaccine is very effective in reducing HPV-related cancers, particularly if people get it when they’re young. A recent British study showed that 13 years after the vaccine was introduced, it cut cervical cancer rates by 87% among young women in the U.K. who were vaccinated between ages 12 and 13. It also protects against genital warts (which are not related to cancer).

Since the vaccine, like all vaccines, is not 100% effective, vaccination still has to be combined with Pap smears or HPV tests to combat cervical cancer, starting at age 21.

“I recommend all children get the HPV vaccine since we know it prevents cancer and saves lives.”

— Dr. Ashley Stephens

Who should get the vaccine and when?
We recommend that all children get the vaccine series between ages 9 to 12 so that they can finish the series before they turn 13, well before they are ever exposed to HPV. We have found that younger people have a better immune response, meaning they generate higher levels of antibodies to protect them from the virus.

Children 14 and under need two shots; the second is given six to 12 months after the first. Children 15 or older should get three shots—the second dose in one to two months after the first shot, and then a third dose six months later. The vaccine is strongly recommended for people up to age 26 and can be given up to age 45, but patients should discuss the benefits of vaccination at an older age with their doctor.

How safe is the vaccine and what are its side effects?
It is very safe, and there are no serious reactions. Most kids don’t get any side effects. But they can have pain, redness, or swelling at the injection site, fever, fatigue, and muscle pain.

Some children can also experience fainting, often due to a fear of needles. If your child is very afraid, they should lie down or have a sip of water or some candy or juice after they are vaccinated to help prevent that from happening.

The benefits of vaccination outweigh the temporary, mild side effects.

How do I prepare my child for getting vaccinated when the time comes?
A lot of kids have heard about cancer before or had a family member affected by it. In my practice, kids will say, “I don’t want a needle.” But when you say, “This is a vaccine that prevents cancer,” many of them say, “Oh, then fine.”

With any vaccine, I reassure the child that it’ll be really quick. If they need it, we can give them pain medication for later if they develop any side effects.

Why are some parents hesitant about the HPV vaccine?
Studies show that some parents worry about the vaccine’s side effects, but the HPV vaccine has been approved since 2006 and has been shown to be very safe and effective, with over 135 million doses given in the U.S. Some parents are worried that their child will start having sex earlier or become promiscuous, or that the vaccine will affect their child’s fertility, but multiple studies have shown that these concerns do not occur.

I oversee a social media campaign—@ENDHPVNYC—made by teens for teens to counter this misinformation and promote positive, factually correct information about the HPV vaccine. In addition, I give talks to physicians and community members about the risks of HPV and the importance of the HPV vaccine.

My hope is that we can get most kids vaccinated for HPV so that we can reduce and even eliminate HPV-related cancers in the future, as is happening in places like Australia. It’s crucial for pediatricians to take the time to explain to parents why the HPV vaccine is important for their child’s health. The most important thing parents can do to protect their children against HPV-related cancer is to get the HPV vaccine years before they are ever exposed to HPV.

Ashley Stephens, M.D., is a primary care pediatrician at the NewYork-Presbyterian Ambulatory Care Network and an assistant professor of pediatrics at Columbia University Vagelos College of Physicians and Surgeons. Her research interests aim to improve childhood and adolescent vaccinations. She is a co-investigator for the Cancer Prevention in Action program aimed at raising awareness about HPV and the HPV vaccine in Staten Island. She also helped develop and oversees the @ENDHPVNYC Instagram campaign to raise awareness about HPV and the HPV vaccine.